What is the Association Between Coronary Angiography Patient Selection and PCI Appropriateness?

Aug 25, 2014

ACC News Story

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In a national sample of NCDR-participating hospitals, a newly published study has found that the performance of coronary angiography in asymptomatic patients is associated with lower rates of appropriate percutaneous coronary intervention (PCI), and higher rates of higher rates of inappropriate PCI. The study aimed to inform strategies that may minimize future inappropriate procedures, and to understand the association between patient selection for coronary angiography and PCI appropriateness.

Based on their findings, the authors conclude that improving pre-procedural risk stratification and thresholds for coronary angiography may be one strategy to improve the appropriateness of PCI. "Our findings suggest patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria," noted Bradley. "Although a strategy of clinical assessment immediately prior to PCI may minimize inappropriate use of the procedure, our findings suggest an opportunity to address patient selection upstream of the catheterization laboratory to optimize use of both angiography and PCI."